atherosclerosis Archives - Hormones Matter

The Dishwasher In My Head: Whooshing from Pulsatile Tinnitus

Published on April 25, 2023

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For months after my stroke, I heard what I can only describe as a dishwasher in my head. The whooshing, which was accompanied by a sensation sort of like when you feel like you need to pop your ears, started in the hospital shortly after I was moved from the ICU to a regular hospital room. When I asked my doctors about the sound in my head, the ongoing whoosh whoosh, they did what they so often did when I asked questions. They looked at me oddly then dismissed it as nothing to worry about. What I saw on their faces was this: “We have no idea what you’re talking about but you really shouldn’t be here so just be happy that you made it.” So I stopped asking about it. In the weeks following my stroke, I experienced it several times a day but after a few months, I would only hear the dishwasher every once in a while. Thankfully, now I only hear it when I am actually washing dishes.

I all but forgot about the dishwasher in my head until I ran across A Quest To Explain the Whooshing In Her Head.

Pulsatile Tinnitus

Apparently, the dishwasher in my head is called “pulsatile tinnitus” but it’s not actually tinnitus at all. Emma Greenwood started the site whooshers.com after experiencing difficulty getting her own pulsatile tinnitus diagnosed. As the site says, “According to many major medical institutions, only 3% of tinnitus sufferers experience pulsatile tinnitus. The rare symptoms create challenges for patients and diagnostic challenges for the medical communities that serve them.” For this reason, she has become a champion of the condition. A quick google search of pulsatile tinnitus shows just how pivotal Greenwood’s work has been. There simply isn’t much information about it and what you can find is usually a side-note to information on tinnitus, though the two aren’t really related.

So What Is It?

Tinnitus is categorized by a “ringing in the ears” or hearing noise that isn’t there and is primarily an auditory condition. This type of tinnitus is usually caused by hearing malfunction. Yet with pulsatile tinnitus, the patient is actually hearing a verifiable sound. These sounds can often be detected by a doctor and, in some cases, people with the condition have even been able to record the sound. If you don’t know what a dishwasher sounds like or you want to hear for yourself what it’s like to have pulsatile tinnitus, you can find audio clips on whooshers.com.

What Causes It?

Pulsatile tinnitus can be caused by abnormalities in the veins or the arteries and it often occurs only in one ear (unless the cause is bilateral). While regular tinnitus is considered more a nuisance than dangerous, pulsatile tinnitus comes with the possibility of some very serious and potentially life-threatening medical conditions. These conditions include:

Vascular stenosis or narrowing of blood vessels which is often caused by atherosclerosis or a thickening of arteries
Aneurysms or a bulging or weak area of an arterial wall
Anatomical variants and abnormalities of the arteries or veins
Intracranial hypertension or pressure in and around the brain (incidentally, this is a side-effect of the Mirena IUD)

One fifteen-year study of 110 patients with pulsatile tinnitus found that most patients had benign swelling of the brain (56) followed by blockage or narrowing of the carotid arteries (24). In 13 patients, no specific diagnosis could be reached.

In another study of 84 patients, a “vascular disorder was found in 36 patients (42%), most commonly a dural arteriovenous fistula or a carotid-cavernous sinus fistula. In 26 patients with a vascular abnormality, pulsatile tinnitus was the presenting symptom. In 12 patients (14%), nonvascular disorders such as glomus tumour or intracranial hypertension with a variety of causes explained the tinnitus.”

Silencing the Whoosh

Though my dishwasher has been silent for years now, I’m grateful that I’ve come across this information. Because my doctors had no idea what I was talking about, it’s not clear what caused my pulsatile tinnitus. My best guess is that I was hearing the sounds of the veins in my head recover from a traumatic brain injury. Now I know that if I ever start to hear it again, I need to have the health of the arteries and veins in my brain examined. And I need to keep looking until I find a doctor who will take me seriously. For now, it’s nice to know that it wasn’t all in my head.

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This post was published originally on Hormones Matter on November 8, 2016.

Do Statins Induce Atherosclerosis and Heart Failure?

by Chandler Marrs, PhD

Published on November 26, 2018

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Statins are some of the most popularly prescribed medications on the market with 1 in 4 Americans taking statin drugs (2011). Do they work? To read the read the early reports statins were wonder drugs, capable of reducing heart attack and extending lifespan with few side effects. No need to change one’s diet or lifestyle, simply take a statin and live longer.

Over the years, the statin market has expanded to include kids as young as 8 years old: “statin therapy is considered first-line treatment for pediatric patients with abnormal lipid levels.” When combined with our love affair with vaccines, the latest proposal includes a cholesterol vaccine for children at risk for heart disease. And since 75% of Americans are still not heeding the anti-cholesterol warning, intense industry lobbying successfully changed the risk equation for statin prescriptions, immediately expanding the market potential by millions more Americans and billions of additional revenue.

Statins for Health – Maybe Not

With 1 and 4 Americans taking statins and cholesterol levels presumably controlled to within the designated healthy ranges, one might expect a concomitant reduction in heart disease and heart disease related mortality across the population. One would be wrong. Despite controlling cholesterol, Americans are as unhealthy as ever, living with increasingly more chronic diseases and dying at higher rates than ever before. Is it possible we were wrong about the relationship between cholesterol and heart function? Is it possible in our exuberance to offer simple solutions to complex disease processes we have been exacerbating the very conditions we seek to treat? Indeed, it is.

Over the last several years, a growing body of evidence suggests that statins are not only not the wonder drugs we had hoped for, but instead, may be quite dangerous, especially for women. Statins induce diabetes (a major contributor to the metabolic dysfunction implicated in coronary artery disease), increase atherogenesis (the buildup fatty plaques responsible for coronary artery disease), and damage mitochondria, an effect that is exacerbated by exercise. As a result, and in non-industry sponsored studies, statin use is associated with higher rates of all-cause mortality, cancer, heart attack, stroke, than non-statin use. Yikes.

Cholesterol Blues

Just how statins induce such negative effects is linked, in large part, to their primary purpose, cholesterol reduction. We need cholesterol. Cholesterol – fat, forms the structure of all cell membranes. We need healthy cell membranes. Fatty acids provide fuel for the production of mitochondrial energy – ATP. ATP is required for all cell functions. Cholesterol is the primary ingredient for steroid hormone synthesis. Steroid hormones regulate everything from reproduction to heart function to central nervous system activity. We need healthy steroid hormone systems. And if those aren’t reasons enough to reconsider cholesterol, the brain needs cholesterol. Reduce the cholesterol in the brain and brain activity deranges, as evidenced by the increasing recognition of statin induced psychiatric and cognitive sequelae. When we reduce cholesterol artificially, we diminish the functioning of every cell in the body by multiple mechanisms.

Cholesterol and Heart Attack

What about the link between high cholesterol and heart attacks? Isn’t it the cholesterol that causes the plaques that block our arteries and cause all sorts of problems? And, aren’t our high fat, high cholesterol diets to blame for this build up? Perhaps not, and especially for women. According to our good friend Kelly Brogan, atherosclerotic plaques and heart disease represent a ‘multi-factorial inflammatory problem with disparate drivers in different people.’ The latest research suggests that these plaques are ‘not merely the passive accumulation of lipids within artery walls‘ but rather represent oxidative stress (mitochondrial damage) with incessant immune mediated inflammatory signals driven by dietary and other factors. This makes sense when we consider that 90% of first time cardiac events can be prevented with dietary and other lifestyle changes and diet and lifestyle effect mitochondrial functioning significantly (the mitochondria drive inflammation).

The most recent research on diet and nutrition suggests diets high in empty calories, carbohydrates and sugars and low in fat are to blame for heart disease, not the high fat diets we have all been taught to avoid. It should be noted, however, that the relationship between fat and health is complex. Too much or too little impairs mitochondrial functioning.

But Wait, There’s More

A research group out of Japan has gone so far as to claim that statins are not only dangerous for the reasons stated above, but statins induce the very diseases they are promoted to protect against. In their most recent publication, Statins Stimulate Atherosclerosis and Heart Failure: Pharmacological Mechanisms, the researchers boldly argue that:

“statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.”

In English – statins block a whole bunch of important chemical reactions that induce coronary artery disease where there was none before. They argue, rather persuasively, that statins cause the very disease process that they are promoted to prevent. Whoa.

According to this research group, statins create the environment where fatty plagues grow and thrive. They derail our innate mechanisms to clear those plaques by damaging the mitochondria and, in so doing, damage the very foundation of cell function: mitochondrial energy (ATP) production. Without functioning mitochondria (which we have written about on many occasions), cell damage and cell death occur. With enough damage, tissue and organ damage ensue, and complex multifaceted disease processes develop. Mitochondria are the engines of health. ATP is the fuel. No fuel, no function. Statins damage the engine and block the fuel line.

What’s Worse?

Statins are frequently co-prescribed with Metformin (gluocophage) to reduce glucose in Type 2 diabetes. Metformin damages mitochondria and reduces ATP production even further (more on this in a subsequent post). Combined, these two drugs set the stage for chronic disease and increase the need for additional medications that will also damage mitochondria; a rabbit hole that is not easily climbed out of unless one is willing to look beyond the medical model. Remember, one of the largest global studies on heart health found that 90% of first time cardiac events in men can be prevented with dietary and other lifestyle changes, 94% in women. Diet and lifestyle. Sit with that for a moment. Diet and lifestyle changes are all that are needed for most people to prevent heart attack. Diet and lifestyle.